Healthcare Provider Details

I. General information

NPI: 1619320397
Provider Name (Legal Business Name): JOSEPH ALEXANDER KERR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 11/08/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E HOSPITAL RD
FORT EISENHOWER GA
30905
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
SAN ANTONIO TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 706-787-5811
  • Fax:
Mailing address:
  • Phone: 210-916-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number79381
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: